Provider Demographics
NPI:1497943443
Name:ZARATE, MARIA ANTONIETTA (LAC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANTONIETTA
Last Name:ZARATE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2749 JACKSON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2924
Mailing Address - Country:US
Mailing Address - Phone:718-361-8293
Mailing Address - Fax:718-383-0853
Practice Address - Street 1:2749 JACKSON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2924
Practice Address - Country:US
Practice Address - Phone:718-361-8293
Practice Address - Fax:718-383-0853
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003619-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist